title: Cardiovascular disease: cause of morbidity and mortality in adult survivors of childhood cancers.
abstract: Although important advances have been made in curing childhood cancer in the last several decades, long-term survivors face considerable morbidity and mortality because of late effects from their initial anticancer therapy. By 30 years after treatment, the cumulative mortality from treatment-related medical illness actually exceeds that of mortality from cancer recurrence. Cardiovascular disease, in particular, is a leading threat to the well-being of adult survivors of childhood cancers. Unfortunately, the mechanisms of these late cardiac effects are understudied and poorly understood. This article reviews cardiotoxicity associated with 2 major anticancer regimens used in treating childhood cancer patients: anthracycline treatment and radiation therapy. The known pathophysiology and clinical cardiac risk factors that further predispose these patients to late-onset cardiac events are discussed. Basic and translational research is urgently needed to clarify pathophysiologic mechanisms of late cardiac effects and to develop therapies to improve both long-term survival and quality of life of adults cured of pediatric cancers.
authors.affiliation: Department of Cardiology, Children's Hospital Boston, 300 Longwood Ave, Boston, MA 02115, USA. minghui.chen@cardio.chboston.org
authors.forename: Ming Hui
authors.initials: MH
authors.lastname: Chen
authors.forename: Steven D
authors.initials: SD
authors.lastname: Colan
authors.forename: Lisa
authors.initials: L
authors.lastname: Diller
mesh_terms: D018943:Anthracyclines / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000009:adverse effects; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000401:mortality*; D006801:Humans; D009369:Neoplasms / Q000628:therapy*; D011878:Radiotherapy / Q000009:adverse effects; D012307:Risk Factors; D015996:Survival Rate
chemical_list: D018943:Anthracyclines; D000970:Antineoplastic Agents